盐酸多奈哌齐联合尼莫地平治疗血管性痴呆的临床观察

Clinical observation on effect of combined aricept and nimodipine in treatment of vascular dementia

目的观察盐酸多奈哌齐联合尼莫地平治疗血管性痴呆(VD)的临床疗效和安全性。方法将轻、中度VD患者57例随机分为联合治疗组、多奈哌齐组、尼莫地平组。联合治疗组服用盐酸多奈哌齐5mg,每晚1次顿服,尼莫地平30mg,每日3次;盐酸多奈哌齐组服用盐酸多奈哌齐5mg,每晚1次顿服;尼莫地平组服用尼莫地平30mg,每日3次。3组疗程均为12周。分别于治疗前、治疗后4周、12周时采用简易智能精神状态检查量表(MMSE)和日常生活活动能力量表(ADL)评定患者的日常生活能力和认知功能;同期行血常规、尿常规、肝肾功能、心电图检查监测其药物安全性。结果联合治疗组、盐酸多奈哌齐组、尼莫地平组治疗后MMSE、ADL评分均较治疗前有改善,MMSE评分:多奈哌齐组(17.4±3.1)分vs(23.1±1.5)分,尼莫地平组(18.1±2.0)分vs(22.3±1.5)分,联合治疗组(17.1±2.3)分vs(24.2±3.2)分(P<0.05);ADL评分:多奈哌齐组(47.3±6.0)分vs(43.1±5.8)分,尼莫地平组(47.8±7.3)分vs(44.1±6.1)分,联合治疗组(48.1±6.9)分vs(41.05±6.2)分(P<0.05),联合治疗组的评分改善优于盐酸多奈哌齐组、尼莫地平组(P<0.05)。在治疗过程中无明显不良反应。结论盐酸多奈哌齐联合尼莫地平能显著改善轻、中度VD患者的认知功能,疗效显著,优于两种药物单独使用,且药物安全性好。

Objective To observe the efficacy and safety of the combination therapy with aricept and nimodipine for patients of vascular dementia （VD）. Methods Fifty-seven patients with mild and severe VD were randomly allocated into combination group,aricept group,nimodipin group. The patients in combination group took aricept 5 mg, once at night,nimodipin 30 mg,three times claily; the patients in aricept group aricept 5 mg, once at night; nimodipin group nimodipin 30 rag, three times daily. The duration of treatment was 12 weeks. Before treatment, after treatment respectively for 4 weeks, 12 weeks, the life ability and cognitive function in the patients were assessed by using Mimimental State Examination （MMSE） and Activities of Daily Living （ADL）; routine blood and urine, liver, and kidney function,electrocardiogram were detected for the drug safety. Results After treatment,the scores of MMSE and ADL were improved in combination group, aricept group, nimodipin group compared with those before treatment,the scores of MMSE：aricept group （17.4± 3.1） scores vs （23.1 4± 1.5） scores, nimodipin group （18.1 ± 2.0） scores vs （22.34±1.5） scores,combination group （17.14±2.3） scores vs （24.24±3.2） scores（ P d0.05） ;the scores of ADL： aricept group （47.34±6.0） scores vs （43.14±5.8） scores,nimodipin group （47.84±7.3） scores vs （44.14±6.1） scores, combination group （48.1 4± 6.9） scores vs （41.0 ± 6.2） scores （ P 〈 0.05）. In the improvements of the scores, the combination group was better than the other two groups （ P 〈0.05）. During the course of treatment no obvious adve;se reaction appeared. Conclusion The combination therapy with nimodipine and aricept markedly improves cognitive function in patients with mild-to-moderate VD, the effect is remarkable and better than the two drugs used alone and the drug safety is good.